This document provides surface landmarks and markings for structures in the head and neck region, including glands, arteries, veins, and nerves. Key landmarks include the parotid gland just above the mandible, the submandibular gland 1.5 cm above the angle of the mandible, the thyroid isthmus 1-1.5 cm below the cricoid cartilage, the common carotid artery at the sternoclavicular joint, and the internal jugular vein from the lobule of the ear to the medial end of the clavicle. Diagrams are included showing the locations and markings of these and other important anatomical structures on the surface.

1. Surface Marking of
Head & Neck region
Dr Shivshanker S Patil
Assistant Professor
Department of Anatomy
ESIC MCH Hyderabad

2. Objectives
1) To study the bony and soft tissue landmarks in head and neck region
2) Surface marking of important structures in Head and neck region
Glands:-
Parotid gland, Submandibular gland, Parotid duct, Thyroid gland
Artery and Veins
Common carotid, External carotid, Internal carotid, Subclavian, Facial, Middle
meningeal artery
Internal Jugular, External jugular veins, Subclavian, Facial vein
Nerves
Cervical sympathetic, Vagus, Glossopharyngeal, Hypoglossal, Accessory, Phrenic
nerve

3. Surface Landmarks- Anterior
Gray’s Atlas 2nd ed
Frontozygomatic suture
Nasion
Supraorbital margin
Zygomatic bone
Mandible
Maxilla
Angle of mandible

4. Surface Landmarks- Lateral
Gray’s Atlas 2nd ed
Glabella
Frontal bone
Pterion
Parietal bone
External occipital
protuberance
Zygomatic arch
Angle of mandible
Mastoid process

5. Surface Landmarks- Posterior
Gray’s Atlas 2nd ed
Parietal bone
External occipital
protuberance
Superior nuchal line
Inferior nuchal line
Spinous process C2
Spinous process C7
Spinous process T1
Temporal bone
Occipital bone

6. Skull : Anatomical position
( Image: Vishram singh)
Frankfurt’s plane - Infraorbital margins and upper margins of external
acoustic meatuses lie in the same horizontal plane.
Orbital cavities are directed forwards, cranium superiorly, mandible inferiorly.

7. Parotid Gland & Duct
1) upper border of the
mandibular condyle
2) just above the centre of
the masseter muscle
3) Posteroinferior to the
angle of mandible
4) Mastoid process
Parotid duct
a) lower border of the tragus
b) midway between the ala of
the nose and the red
margin of the upper lip
Duct is represented by middle
third of this line
A K Datta Human Anatomy 4th ed

8. Submandibular Gland
1) Angle of mandible
2) Midpoint b/w angle and
symphysis menti
3) 1.5 cms above the
midpoint of these two
points
4) A point just above tip of
greater cornu of hyoid
bone
A K Datta Human Anatomy 4th ed

9. Thyroid Gland
Isthmus
1) draw 1.5 cm horizontal line 1 cm
below cricoid cartilage
2) Another line ½ inch below the
previous line
Lateral lobes
a) A point 1 cm below and lateral to
isthmus
b) A point 2.5 cm lateral to previous
point
c) A point on anterior border of
sternocleidomastoid at the level
of laryngeal prominence
A K Datta Human Anatomy 4th ed

10. Facial Artery & Vein
1) Antero-inferior
border of the
masseter muscle
on mandible
2) 1.2 cm lateral to
the angle of the
mouth
3) medial angle of
the eye
Tortuous course
between 1 and 2
Facial Vein:
A straight line drawn
b/w point 1 and 3
A K Datta Human Anatomy 4th ed

11. Middle Meningeal Artery
1) First point above tragus
Preauricular point
2) second point 2 cm above
the first point
3) third point (pterion) 4 cm
above zygomatic arch
4) fourth point midway
between the nasion and
inion.
5) fifth point (lambda) 5 cm
above the external occipital
protuberance.
A K Datta Human Anatomy 4th ed

12. Common Carotid artery
1) sternoclavicular joint
2) anterior border of the
sternocleidomastoid
muscle at the level of
upper border of the
thyroid cartilage
A K Datta Human Anatomy 4th ed

13. Internal Carotid Artery
1) anterior border of the
sternocleidomastoid muscle at
the level of upper border of
thyroid cartilage
2) posterior border of the
condyle of the mandible
A K Datta Human Anatomy 4th ed

14. External Carotid Artery
1) point on the anterior
border of the
sternocleidomastoid
muscle at the level of the
upper border of the thyroid
cartilage
2) A point midway b/w angle of
mandible and tip of mastoid
process
A slightly convex line b/w
these two points
A K Datta Human Anatomy 4th ed

15. Subclavian Artery
1) a point sternoclavicular joint
2) A point on the middle of
lower border of the clavicle
A K Datta Human Anatomy 4th ed

16. Internal Jugular vein
1) lobule of the ear
2) medial end of the
clavicle
A K Datta Human Anatomy 4th ed

17. External Jugular Vein
1) point just below and
behind the angle of the
mandible
2) upper border clavicle just
lateral to the posterior
border of the
sternocleidomastoid
A K Datta Human Anatomy 4th ed

18. Subclavian Vein
1) a point little medial to its
midpoint to lower border of
clavicle
2) medial end of the clavicle
A K Datta Human Anatomy 4th ed

19. Blood vessels of the Neck
A K Datta Human Anatomy 4th ed

20. Accessory Nerve
1) A point below and front of
Tragus
2) A point on the tip of
transverse process of atlas
3) Point on anterior border of
sternocleidomastoid upper
1/3 and lower 2/3
4) Midpoint of posterior border
of sternocleidomastoid
5) A point on anterior border of
trapezius around 5 cm above
clavicle
A K Datta Human Anatomy 4th ed

21. Vagus Nerve
1) A point below and front of
Tragus
2) Medial end of clavicle
A K Datta Human Anatomy 4th ed

22. Hypoglossal Nerve
1) A point below and front of
Tragus
2) Point above and behind tip
of greater cornu of Hyoid
bone
3) A point midway b/w angle
and symphysis menti of
mandible
A K Datta Human Anatomy 4th ed

23. Glossopharyngeal Nerve
1) A point below and front of
Tragus
2) A point slightly above the
angle of mandible
Thick line joining these two
point and continued in front
along lower border mandible
A K Datta Human Anatomy 4th ed

24. Phrenic Nerve
1) A point 3.5 cm lateral to
median plane at the level of
Thyroid cartilage
2) A point midway b/w anterior
and posterior border of
sternocleidomastoid at the
level of cricoid cartilage
3) A point on sternal end of
clavicle
A K Datta Human Anatomy 4th ed

25. Sympathetic trunk
1) a point posterior to condyle
of mandible
2) a point on the
sternoclavicular joint
Superior cervical ganglion
Spindle from transverse process
of atlas to level of greater cornu
of hyoid bone
Middle cervical ganglion
Small circle opposite the level
of cricoid cartilage
Inferior cervical ganglion
A small circle 3cm above the
sternoclavicular joint
A K Datta Human Anatomy 4th ed

26. Brachial plexus
1) a point midway b/w
anterior and posterior
border of
sternocleidomastoid at the
level of cricoid cartilage
2) A point at the junction of
clavicle and posterior
border of
sternocleidomastoid
3) A point just lateral to
midpoint of clavicle
A K Datta Human Anatomy 4th ed

27. Facial nerve
1) First point on the
anterior border of
mastoid process
2) A point behind the neck
of mandible
A K Datta Human Anatomy 4th ed